Provider Demographics
NPI:1740332659
Name:BURBA, LINDA A (AUD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:A
Last Name:BURBA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:487 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-4403
Mailing Address - Country:US
Mailing Address - Phone:630-858-3277
Mailing Address - Fax:630-858-6832
Practice Address - Street 1:487 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-4403
Practice Address - Country:US
Practice Address - Phone:630-858-3277
Practice Address - Fax:630-858-6832
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147-000099231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL995940Medicare ID - Type Unspecified